NURS 615 PHARM EXAM 1 – MARYVILLE
ACTUAL EXAM BANK COMPLETE 350
QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) |ALREADY
PASSED!! BRAND NEW
What is the efficacy of a drug? - CORRECT ANSWER ✔✔- Efficacy is the maximum
response achievable from a drug. Effectiveness refers to the ability of the drug to
produce a beneficial effect.
On the drug concentration curve what is the first sign of a therapeutic effect? -
CORRECT ANSWER ✔✔- The onset of action
What is the purpose of a peak and trough level? - CORRECT ANSWER ✔✔- To
determine if the drug is in therapeutic range.
Describe the purpose of blood brain barrier - CORRECT ANSWER ✔✔- The BBB is a
highly selective permeability barrier that separates the circulating blood from the
brain and extracellular fluid in the CNS. The BBB is formed by brain endothelial
cells which are connected by tight junctions with an extremely high electrical
resistivity of at least 0.1 micron. The BBB allows the passage of water, some
gases, and lipid soluble molecules by passive diffusion as well as the selective
transport molecules such as glucose and amino acids that are crucial to neuro
function.
Describe the purpose of the fetal placental barrier - CORRECT ANSWER ✔✔- the
so-called placental barrier impedes certain chemicals although it allows most fat
1|Page
,soluble chemicals to cross. Drugs that are more water soluble and that possess a
higher molecular weight tend not to cross the placental barrier. In addition, if a
drug binds to a large molecule, such as a blood-borne protein like albumin, it is
even less likely to come into contact with fetus.
How will renal insufficiency affect drug elimination? - CORRECT ANSWER ✔✔- The
kidney is the primary organ of excretion for most drugs. General theme of
metabolism is to produce drug metabolites that are more water soluble and more
easily removed by the kidneys. The rate at which the drug is excreted by the
kidneys depends on several factors. Renal blood flow influences the glomerular
filtration rate (GFR) which is how much plasma is filtered per minute by the
glomerulus.
Renal excretion of drugs is typically well-characterized, what is variable is the -
CORRECT ANSWER ✔✔- level of renal function the patient.
It is common to monitor renal function in patients by the clinical setting and to
adjust dosages based on renal function. This is typically assessed by the -
CORRECT ANSWER ✔✔- serum creatinine.
Patients with poor renal function may have higher levels of drugs secondary to -
CORRECT ANSWER ✔✔- decreased excretion of metabolites.
What is off-label prescribing? - CORRECT ANSWER ✔✔- Off-label use is the use of
pharmaceutical drugs for an unapproved indication or an unapproved age group,
dosage or route of administration.
What factors place an infant and child at risk when prescribing medication? -
CORRECT ANSWER ✔✔- In general, there is a lack of safety and efficacy studies in
2|Page
,the pediatric population most medications are studied in adult populations which
because of age-related differences and medication metabolism and mechanisms
of action don't necessarily apply to pediatric populations. Children are not just
small adults. Adverse drug reactions are most common in this age group. Kids do
not have a fully mature liver and renal function, and are at higher risk for toxicity
and adverse drug effects.
In kids, meds should be - CORRECT ANSWER ✔✔- weight based. Kids do not have
a fully mature liver and renal function, and are at higher risk for toxicity and
adverse drug effects.
What ADRs are the elderly at risk of developing? - CORRECT ANSWER ✔✔-
Physiologic changes in older adults increase the risk of harm for medication
metabolized by the liver and kidneys.
In the elderly, Hepatic blood flow decreases by - CORRECT ANSWER ✔✔- nearly
one-half or 40% in older adults.
some degree of chronic kidney disease is present in X of older adult - CORRECT
ANSWER ✔✔- 50%
Furthermore, the median renal blood flow decreases by X by the time the patient
reaches 80 years of age, and x - CORRECT ANSWER ✔✔- x of older adults maintain
normal kidney function/50%, 1/3. Although, the normal individual rate of decline
varies and one-third of older adults maintain normal renal function.
Heart failure, which affects more than forty percent of persons older than 80
years, can - CORRECT ANSWER ✔✔- further reduce the function of the aging
kidneys and liver.
3|Page
, Other factors influence pharmacokinetics in older adults include - CORRECT
ANSWER ✔✔- aging decreases first-pass clearance in the liver, and a number of
commonly prescribed medications like warfarin, benzos, and opiates require
much lower doses in older adults. Distribution of drugs to body compartments
has changed by the decrease in the ratio of lean body weight to body fat. Levels
of serum protein, which bind many drugs, decrease in older adults because of
malnutrition and dietary changes that are common for both intentional and
unintentional regions. Drug metabolism can be affected by substance abuse
including alcohol, up to ten percent of older adults are heavy or problem drinkers.
Polypharmacy.
What are the adverse drug reactions related to special populations? - CORRECT
ANSWER ✔✔- These can come into the categories of genetics, age, gender, drug
interactions, and medical conditions.
Type 1 hypersensitivity or immediate hypersensitivity is an - CORRECT ANSWER
✔✔- allergic reaction provoked by re-exposure to a specific type of antigen,
referred to as an allergen. Symptoms vary from mild irritation to sudden death
from anaphylactic shock, called type 1 anaphylactic shock.
In type 2 hypersensitivity or cytotoxic hypersensitivity, - CORRECT ANSWER ✔✔-
the antibodies produced in the immune response bind to antigens of the patients
on cell surfaces. The antigens recognized in the way may either be intrinsic (a self-
antigen, part of the patient's cells) or extrinsic (absorbed onto the cells during
exposure to some foreign pathogens possibly as part of an infection with a
pathogen).
An example of type 2 hypersensitivity is the - CORRECT ANSWER ✔✔- ABO blood
incompatibility where the red blood cells have different antigens causing them to
4|Page
ACTUAL EXAM BANK COMPLETE 350
QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) |ALREADY
PASSED!! BRAND NEW
What is the efficacy of a drug? - CORRECT ANSWER ✔✔- Efficacy is the maximum
response achievable from a drug. Effectiveness refers to the ability of the drug to
produce a beneficial effect.
On the drug concentration curve what is the first sign of a therapeutic effect? -
CORRECT ANSWER ✔✔- The onset of action
What is the purpose of a peak and trough level? - CORRECT ANSWER ✔✔- To
determine if the drug is in therapeutic range.
Describe the purpose of blood brain barrier - CORRECT ANSWER ✔✔- The BBB is a
highly selective permeability barrier that separates the circulating blood from the
brain and extracellular fluid in the CNS. The BBB is formed by brain endothelial
cells which are connected by tight junctions with an extremely high electrical
resistivity of at least 0.1 micron. The BBB allows the passage of water, some
gases, and lipid soluble molecules by passive diffusion as well as the selective
transport molecules such as glucose and amino acids that are crucial to neuro
function.
Describe the purpose of the fetal placental barrier - CORRECT ANSWER ✔✔- the
so-called placental barrier impedes certain chemicals although it allows most fat
1|Page
,soluble chemicals to cross. Drugs that are more water soluble and that possess a
higher molecular weight tend not to cross the placental barrier. In addition, if a
drug binds to a large molecule, such as a blood-borne protein like albumin, it is
even less likely to come into contact with fetus.
How will renal insufficiency affect drug elimination? - CORRECT ANSWER ✔✔- The
kidney is the primary organ of excretion for most drugs. General theme of
metabolism is to produce drug metabolites that are more water soluble and more
easily removed by the kidneys. The rate at which the drug is excreted by the
kidneys depends on several factors. Renal blood flow influences the glomerular
filtration rate (GFR) which is how much plasma is filtered per minute by the
glomerulus.
Renal excretion of drugs is typically well-characterized, what is variable is the -
CORRECT ANSWER ✔✔- level of renal function the patient.
It is common to monitor renal function in patients by the clinical setting and to
adjust dosages based on renal function. This is typically assessed by the -
CORRECT ANSWER ✔✔- serum creatinine.
Patients with poor renal function may have higher levels of drugs secondary to -
CORRECT ANSWER ✔✔- decreased excretion of metabolites.
What is off-label prescribing? - CORRECT ANSWER ✔✔- Off-label use is the use of
pharmaceutical drugs for an unapproved indication or an unapproved age group,
dosage or route of administration.
What factors place an infant and child at risk when prescribing medication? -
CORRECT ANSWER ✔✔- In general, there is a lack of safety and efficacy studies in
2|Page
,the pediatric population most medications are studied in adult populations which
because of age-related differences and medication metabolism and mechanisms
of action don't necessarily apply to pediatric populations. Children are not just
small adults. Adverse drug reactions are most common in this age group. Kids do
not have a fully mature liver and renal function, and are at higher risk for toxicity
and adverse drug effects.
In kids, meds should be - CORRECT ANSWER ✔✔- weight based. Kids do not have
a fully mature liver and renal function, and are at higher risk for toxicity and
adverse drug effects.
What ADRs are the elderly at risk of developing? - CORRECT ANSWER ✔✔-
Physiologic changes in older adults increase the risk of harm for medication
metabolized by the liver and kidneys.
In the elderly, Hepatic blood flow decreases by - CORRECT ANSWER ✔✔- nearly
one-half or 40% in older adults.
some degree of chronic kidney disease is present in X of older adult - CORRECT
ANSWER ✔✔- 50%
Furthermore, the median renal blood flow decreases by X by the time the patient
reaches 80 years of age, and x - CORRECT ANSWER ✔✔- x of older adults maintain
normal kidney function/50%, 1/3. Although, the normal individual rate of decline
varies and one-third of older adults maintain normal renal function.
Heart failure, which affects more than forty percent of persons older than 80
years, can - CORRECT ANSWER ✔✔- further reduce the function of the aging
kidneys and liver.
3|Page
, Other factors influence pharmacokinetics in older adults include - CORRECT
ANSWER ✔✔- aging decreases first-pass clearance in the liver, and a number of
commonly prescribed medications like warfarin, benzos, and opiates require
much lower doses in older adults. Distribution of drugs to body compartments
has changed by the decrease in the ratio of lean body weight to body fat. Levels
of serum protein, which bind many drugs, decrease in older adults because of
malnutrition and dietary changes that are common for both intentional and
unintentional regions. Drug metabolism can be affected by substance abuse
including alcohol, up to ten percent of older adults are heavy or problem drinkers.
Polypharmacy.
What are the adverse drug reactions related to special populations? - CORRECT
ANSWER ✔✔- These can come into the categories of genetics, age, gender, drug
interactions, and medical conditions.
Type 1 hypersensitivity or immediate hypersensitivity is an - CORRECT ANSWER
✔✔- allergic reaction provoked by re-exposure to a specific type of antigen,
referred to as an allergen. Symptoms vary from mild irritation to sudden death
from anaphylactic shock, called type 1 anaphylactic shock.
In type 2 hypersensitivity or cytotoxic hypersensitivity, - CORRECT ANSWER ✔✔-
the antibodies produced in the immune response bind to antigens of the patients
on cell surfaces. The antigens recognized in the way may either be intrinsic (a self-
antigen, part of the patient's cells) or extrinsic (absorbed onto the cells during
exposure to some foreign pathogens possibly as part of an infection with a
pathogen).
An example of type 2 hypersensitivity is the - CORRECT ANSWER ✔✔- ABO blood
incompatibility where the red blood cells have different antigens causing them to
4|Page
